Paradoxical Relationship Between Glycated Hemoglobin and Longitudinal Change in Physical Functioning in Older Adults: A Prospective Cohort Study

Hyperglycemia with high hemoglobin A1c (HbA1c) levels is associated with significant health risks. However, the relationship between HbA1c levels and the physical functioning status in later life remains uncertain and so is the possible underlying mechanism. We conducted a prospective study of 2,565...

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Published in:The journals of gerontology. Series A, Biological sciences and medical sciences Biological sciences and medical sciences, 2019-05, Vol.74 (6), p.949-956
Main Authors: Wu, I-Chien, Hsu, Chih-Cheng, Chen, Ching-Yu, Chuang, Shu-Chun, Cheng, Chiu-Wen, Hsieh, Wan-Shan, Wu, Ming-Shiang, Liu, Yen-Tze, Liu, Yo-Hann, Tsai, Tsung-Lung, Lin, Cheng-Chih, Hsiung, Chao A
Format: Article
Language:English
Subjects:
Aged
Aging
Aging - physiology
Biomarkers - blood
Cohort analysis
Cohort Studies
Female
Frailty
Gerontology
Glycated Hemoglobin A - analysis
Health risks
Hemoglobin
Humans
Hyperglycemia
Inflammation
Interleukin 6
Longitudinal Studies
Male
Motor ability
Older people
Physical disabilities
Receptors, Interleukin-6 - blood
Taiwan
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container_title The journals of gerontology. Series A, Biological sciences and medical sciences
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creator Wu, I-Chien
Hsu, Chih-Cheng
Chen, Ching-Yu
Chuang, Shu-Chun
Cheng, Chiu-Wen
Hsieh, Wan-Shan
Wu, Ming-Shiang
Liu, Yen-Tze
Liu, Yo-Hann
Tsai, Tsung-Lung
Lin, Cheng-Chih
Hsiung, Chao A
description Hyperglycemia with high hemoglobin A1c (HbA1c) levels is associated with significant health risks. However, the relationship between HbA1c levels and the physical functioning status in later life remains uncertain and so is the possible underlying mechanism. We conducted a prospective study of 2,565 initially well-functioning community-dwelling older adult aged 55 years and older from the Healthy Aging Longitudinal Study in Taiwan. Each participant received baseline measurements of blood HbA1c and inflammatory markers levels and repeated assessments of physical functioning over a mean follow-up period of 5.3 years. We used generalized linear mixed-effects regression to estimate the adjusted changes in the odds ratio for self-reported physical functioning impairment and Short Physical Performance Battery (SPPB) score according to baseline HbA1c levels (categorized into 0.5% increments from
doi_str_mv 10.1093/gerona/gly147
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However, the relationship between HbA1c levels and the physical functioning status in later life remains uncertain and so is the possible underlying mechanism. We conducted a prospective study of 2,565 initially well-functioning community-dwelling older adult aged 55 years and older from the Healthy Aging Longitudinal Study in Taiwan. Each participant received baseline measurements of blood HbA1c and inflammatory markers levels and repeated assessments of physical functioning over a mean follow-up period of 5.3 years. We used generalized linear mixed-effects regression to estimate the adjusted changes in the odds ratio for self-reported physical functioning impairment and Short Physical Performance Battery (SPPB) score according to baseline HbA1c levels (categorized into 0.5% increments from &lt;5.5% to ≥7.0%). HbA1c levels showed a U-shaped relationship with changes in the odds ratio for physical functioning impairment and SPPB score (p for quadratic term &lt; .001). Compared with participants with an HbA1c of 5.5% to &lt;6.0%, those with an HbA1c of &lt;5.5% or ≥7.0% had a higher annual increase in the odds ratio for physical functioning impairment (odds ratio [95% confidence interval] per year, 1.25 [1.04-1.50] and 1.21 [1.04-1.41]) and a higher annualized decrease in SPPB score (coefficient [95% confidence interval], -0.05 [-0.10 to 0.00] and -0.04 [-0.08 to 0.00]). These relationships were nonlinear only in participants with high soluble interleukin-6 receptor levels (&gt;48,124 pg/mL; p for interaction &lt; .05). High and low HbA1c levels at baseline are associated with faster physical functioning decline, particularly among individuals with elevated circulating soluble interleukin-6 receptor, a sign of enhanced interleukin-6 trans-signaling.</description><identifier>ISSN: 1079-5006</identifier><identifier>EISSN: 1758-535X</identifier><identifier>DOI: 10.1093/gerona/gly147</identifier><identifier>PMID: 31095709</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Aged ; Aging ; Aging - physiology ; Biomarkers - blood ; Cohort analysis ; Cohort Studies ; Female ; Frailty ; Gerontology ; Glycated Hemoglobin A - analysis ; Health risks ; Hemoglobin ; Humans ; Hyperglycemia ; Inflammation ; Interleukin 6 ; Longitudinal Studies ; Male ; Motor ability ; Older people ; Physical disabilities ; Receptors, Interleukin-6 - blood ; Taiwan</subject><ispartof>The journals of gerontology. Series A, Biological sciences and medical sciences, 2019-05, Vol.74 (6), p.949-956</ispartof><rights>The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. 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Series A, Biological sciences and medical sciences</title><addtitle>J Gerontol A Biol Sci Med Sci</addtitle><description>Hyperglycemia with high hemoglobin A1c (HbA1c) levels is associated with significant health risks. However, the relationship between HbA1c levels and the physical functioning status in later life remains uncertain and so is the possible underlying mechanism. We conducted a prospective study of 2,565 initially well-functioning community-dwelling older adult aged 55 years and older from the Healthy Aging Longitudinal Study in Taiwan. Each participant received baseline measurements of blood HbA1c and inflammatory markers levels and repeated assessments of physical functioning over a mean follow-up period of 5.3 years. 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These relationships were nonlinear only in participants with high soluble interleukin-6 receptor levels (&gt;48,124 pg/mL; p for interaction &lt; .05). 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Series A, Biological sciences and medical sciences</jtitle><addtitle>J Gerontol A Biol Sci Med Sci</addtitle><date>2019-05-16</date><risdate>2019</risdate><volume>74</volume><issue>6</issue><spage>949</spage><epage>956</epage><pages>949-956</pages><issn>1079-5006</issn><eissn>1758-535X</eissn><abstract>Hyperglycemia with high hemoglobin A1c (HbA1c) levels is associated with significant health risks. However, the relationship between HbA1c levels and the physical functioning status in later life remains uncertain and so is the possible underlying mechanism. We conducted a prospective study of 2,565 initially well-functioning community-dwelling older adult aged 55 years and older from the Healthy Aging Longitudinal Study in Taiwan. Each participant received baseline measurements of blood HbA1c and inflammatory markers levels and repeated assessments of physical functioning over a mean follow-up period of 5.3 years. We used generalized linear mixed-effects regression to estimate the adjusted changes in the odds ratio for self-reported physical functioning impairment and Short Physical Performance Battery (SPPB) score according to baseline HbA1c levels (categorized into 0.5% increments from &lt;5.5% to ≥7.0%). HbA1c levels showed a U-shaped relationship with changes in the odds ratio for physical functioning impairment and SPPB score (p for quadratic term &lt; .001). Compared with participants with an HbA1c of 5.5% to &lt;6.0%, those with an HbA1c of &lt;5.5% or ≥7.0% had a higher annual increase in the odds ratio for physical functioning impairment (odds ratio [95% confidence interval] per year, 1.25 [1.04-1.50] and 1.21 [1.04-1.41]) and a higher annualized decrease in SPPB score (coefficient [95% confidence interval], -0.05 [-0.10 to 0.00] and -0.04 [-0.08 to 0.00]). These relationships were nonlinear only in participants with high soluble interleukin-6 receptor levels (&gt;48,124 pg/mL; p for interaction &lt; .05). High and low HbA1c levels at baseline are associated with faster physical functioning decline, particularly among individuals with elevated circulating soluble interleukin-6 receptor, a sign of enhanced interleukin-6 trans-signaling.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>31095709</pmid><doi>10.1093/gerona/gly147</doi><tpages>8</tpages></addata></record>
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identifier ISSN: 1079-5006
ispartof The journals of gerontology. Series A, Biological sciences and medical sciences, 2019-05, Vol.74 (6), p.949-956
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source Oxford Journals Online; Sociological Abstracts
subjects Aged
Aging
Aging - physiology
Biomarkers - blood
Cohort analysis
Cohort Studies
Female
Frailty
Gerontology
Glycated Hemoglobin A - analysis
Health risks
Hemoglobin
Humans
Hyperglycemia
Inflammation
Interleukin 6
Longitudinal Studies
Male
Motor ability
Older people
Physical disabilities
Receptors, Interleukin-6 - blood
Taiwan
title Paradoxical Relationship Between Glycated Hemoglobin and Longitudinal Change in Physical Functioning in Older Adults: A Prospective Cohort Study
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